1.1 Dyspepsia and Gastro-oesophageal reflux disease
Co-magaldrox (magnesium hydroxide 195mg, dried aluminium hydroxide 220mg/mL) available as Mucogel® (sugar-free suspension) is an effective antacid with a low sodium content (less than 1mmol per 10mL dose).
Peptac® (sugar-free suspension containing sodium alginate 250mg, sodium bicarbonate 133.5mg and calcium carbonate 80mg/5mL) is the most cost-effective liquid compound alginic acid preperation and is only recommended for the treatment of gastric reflux as it has low acid suppressant activity. It has a high sodium content (6.2mmol per 10mL dose).
Gaviscon® Advance (sugar-free suspension containing sodium alginate 500mg, potassium bicarbonate 100mg/5mL is an alternative to Peptac® for the treatment of gastric reflux only in patients where the lower sodium content may be considered advantageous. It has a lower standard dose and contains 2.3mmol sodium and 1mmol potassium per 5mL dose. It is also available in a tablet formulation (containing sodium alginate 500mg and potassium bicarbonate 100mg/tablet).
Co-simalcite 125/500 available as Altacite Plus® (sugar-free suspension containing simeticone 125mg, hydrotalcite 500mg/5mL) is used for the treatment of biliary gastritis and is initiated in hospital.
Citrate antacid mixture is used pre-op in patients undergoing elective caesarean section.
PRESCRIBING POINTS FOR DYSPEPSIA AND GASTRO-OESOPHAGEAL REFLUX DISEASE
- Offer simple advice regarding lifestyle factors that may affect reflux.
- Liquid preparations are more effective than tablets.
- Antacids are best given when symptoms occur or are expected, usually between meals and at bedtime - four or more times daily.
- Antacids, taken at the same time as other drugs, may impair their absorption. They may also damage enteric coatings designed to prevent irritant drugs from dissolving in the stomach.